Sometimes IT Band syndrome just happens. Sometimes it goes away with conservative therapy and sometimes it doesn't.

My fit is good, I am as flexible as a ballerina, train with care, can do my rolling on a wooden rolling pin , no muscle imbalance, good biomechanics, etc. and I have IT Band Syndrome in both legs. It started in the right knee and while undergoing therapy it appeared in my left. I have exhausted every imaginable therapy. The good news is that surgery is very effective for this particular problem. I will have both knees done ASAP.

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What surgery is that? Double amputation?

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Snacking on carrot sticks - Where did it all go so wrong?
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Finsbury Park CC

although surgery is rarely required/indicated, there are numerous surgical techniques with varying success... Lengthening "plasty" techniques, band releases, and underlying boney condylar removal/remodeling....

Forget the nonsense. ITB syndrome, where pain is caused by the IT Band irritating the underlying bursa like tissue as it crosses the lateral epicondyle of the femur, can be cured permanently by a resection of the IT Band and a bursectomy deep to the band. In other words a triangle with a base of 2 cm and a height of 1.5 centimetres is removed from the posterior of the IT Band where it crossed the bump at the end of the femur. Irritated tissue underneath the IT Band in the area of the removed triangle is scraped away.

Another procedure where simply the bursa like tissue in the affected area is removed without resecting the band has been pioneered by a surgeon in Belgium. In a study of 32 knees he (Michels et al) had good to excellent results in 30 or 31. The advantage is faster recovery. Activity in days and full training in just a few weeks.

The one issue I have with most of the knowledge base around IT Band Syndrome is that it mostly involves runners. I can find nothing specific to cyclists.

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I thought u said forget the nonsense? Clearly not?

By nonsense I mean re-modelling of the femur. Short of some deformity, that is a rather extreme approach when much less invasive and proven techniques are available.

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I was outlining some of the techniques that have used in the surgical management of ITB issues. Granted some have relatively no merit, and some in specific cases.

The technique u describe has some good outcomes reported, and if I was having my ITB done then it is what I would probably choose as well. Having said that, I'm sure you'll agree that unless all of the setup and biomechanical issues u have previously outlined have been addressed by someone experienced to the nth degree then a long term positive result is unlikely. That is the key here.



Smoothing of the femoral surface underlying the ITB is a reasonably common adjunct for those with irregular femoral surfaces, or chronically calcified tendons, where this I thought to be a factor. Sorry I wasn't more descriptive...

Thanks Doc, that makes more sense.

FYI for all those ITB sufferers, do not give up without trying the Patt Strap. The damn thing really works.

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Not sure if you are referring to me or the OP. FWIW I run my seat a bit lower than most recommend. I also use short relatively short cranks for someone of my size.

Had my first surgery a month ago, still recovering will report back. Will do the other knee in about 6 months.

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Surgery seems successful. 10 weeks post surgery and I can already ride longer and harder than prior to surgery. No sign of IT Band syndrome but there is some post surgery discomfort after hard efforts. Pain is different and very minor and getting less each ride. The other knee is scheduled for the same procedure at the end of next month.

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